Effect of neoadjuvant therapy on the risk for atrial fibrillation in patients undergoing esophagectomy.

Abstract

210 Background: Neoadjuvant chemoradiation (NT) has become the standard for patients with locally advanced esophageal cancer. Thirty percent of patients who undergo esophagectomy will develop atrial fibrillation (AF). NT may contribute to patients developing AF and this may be a surrogate for anastomotic dehiscence (AD). Methods: We queried a prospective esophageal database to identify patients who underwent esophagectomy with or without NT. Demographics and post-operative complications were all compared with fisher exact test and considered significant at p<0.05. Results: We identified 811 patients who underwent esophagectomy with a mean age of 68 +/- 12 years. Five-hundred and fifteen (63.5%) were treated with NT and 296 (36.5%) were not. Eighty-nine (11%) of patients developed AF, 59 (11.5%) in the NT group, and 30 (10.1%) in the non NT group. There was no significant differences noted in the incidence of AF in those that were treated with NT and those that were not (p=0.64). A total of 54 (6.7%) patients were identified as having AD, 27 (5.2%) in the NT cohort and 27 (9.1%) in the non NT cohort. The NT group had lower incidence of AD compared to their non NT counterparts (p=0.04). Of the 54 patients who experienced AD, 6 (11%) had concomitant AF, and 48 (89%) did not and the remaining 83 patients who developed AF did not develop AD (p=1). Conclusions: NT prior to esophagectomy does not increase patient’s risk for developing postoperative AF. Moreover, the presence of AF in the post esophagectomy patient, did not serve as a surrogate for identifying AD.